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Updated: Dec 1, 2025

Intralymphatic Immunotherapy and Vaccination in Mice
Published on: February 2, 2014
Severe lymphopenia after subcutaneous cladribine in a patient with multiple sclerosis: To vaccinate or not?
M Mateo-Casas1,2, S Reyes3,2, S De Trane3,2
1Department of Neurology, Hospital General Universitario de Castellón, Castellón de la Plana, Spain.
Objective:
To describe a fatal case of influenza A pneumonia in a patient with severe lymphopenia after receiving subcutaneous cladribine to treat her multiple sclerosis (MS).
Methods:
Case report.
Results:
A 53-year-old woman developed fatal influenza pneumonia associated with grade 4 lymphopenia two months after receiving a total dose of 60mg subcutaneous cladribine. Despite treatment with oseltamivir, her condition deteriorated and the patient passed away after developing respiratory failure.
Conclusion:
Cladribine-related lymphopenia is usually mild to moderate, however severe lymphopenia may occur. People with MS, especially those who are immunosuppressed, should be offered the inactivated influenza vaccine annually.
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